Hidradenitis Suppurativa and Skin Cancer

Again, SCC is most often caused by too much sun exposure. This may sometimes be the case for people with HS who develop SCC in areas of skin that aren’t typically hidden in skin folds or by clothing. Other factors, including chronic inflammation and immunosuppression, may also play a role in how squamous cell cancer occurs and behaves when it’s associated with HS.

A chief concern is inflammation, which can make any type of cancer worse, says Luis Andres Garza, MD, PhD, a professor of dermatology at Johns Hopkins University School of Medicine in Baltimore. The inflammation that happens in the body from HS may be part of the increased likelihood of squamous cell skin cancer, he adds.

Certain treatments for HS may ratchet up the risk of SCC. Some HS medications suppress the immune system, for example, which is linked to a higher risk of developing skin cancer, says Dr. Garza. One study, for example, found that immunosuppression is an independent risk factor associated with worse outcomes in those who have cutaneous, or skin-based, squamous cell carcinoma.

Another unique factor of squamous cell carcinoma in HS is location. “HS primarily occurs in places where skin rubs on skin,” says Rita Pichardo, MD, a dermatologist at Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina, who runs an HS clinic. “These regions can be chronically inflamed for many years. That makes certain regions in the body — the vulvar, perianal, and perineal areas — especially prone to developing skin cancer.”

A review of studies published in 2021 looked at SCC as a result of HS and found that the most common sites of the cancer were the buttocks, the perianal region, and the genitals.

SCC may also be more likely to spread and even cause death in people with HS than in otherwise healthy people. In the 2021 review, for instance, in more than half of the people (mostly male) with HS who developed squamous cell growths, the cancer metastasized. Over 40 percent of them had a recurrence of SCC, and more than 58 percent ultimately died, most commonly of metastases or sepsis.

Lastly, chronic wounds — like the persistent lesions that characterize HS — are associated with a type of skin cancer that frequently takes the form of squamous cell carcinoma, adds Garza. Known as Marjolin’s ulcer, this rare, aggressive skin cancer develops in scar tissue, chronic ulcers, and areas affected by inflammation.

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7 Ways to Get Rid of a Sinus Headache Right Now

1. Use a Humidifier

When mucus is thin, your sinuses naturally clear out. But when the mucus becomes thick and blocks drainage, the sinus pressure builds, causing pain associated with a sinus headache, Reddy says.

But adding moisture to the air using a humidifier helps keep the mucus thin and aids with draining and reducing pressure in the sinuses. “Moist air thins mucus, which can otherwise be thick and sticky when the sinuses are inflamed,” Reddy says. Research shows that the sinuses efficiently self-clean when the humidity level is at least 30 percent, or even better, 45 percent.

If you don’t currently have a humidifier, take steamy showers and expose yourself to humidity by drinking plenty of hot fluids (like tea and soup), which also help with hydration, Reddy says.

2. Try a Saline Nasal Spray

Saline nasal sprays — sterile saltwater solutions that you squirt into your nostrils — can help moisturize and cleanse the nasal passages.

 They also help rinse out allergens, dust, and thick mucus from the sinuses, Reddy says. “This cleaning action allows the sinus passages to open up, reducing pressure and easing sinus headache pain.”

Saline nasal sprays don’t contain any medication, and they’re safe to use as often as you need, Reddy says. You can buy a saline nasal spray from your local drugstore.

3. Try Nasal Irrigation

Rinsing your sinuses using nasal irrigation can help clear the passageways and provide relief. You can use a saline solution along with a sinus rinse bottle, neti pot, or bulb syringe irrigation kit, which are all likely available at your local pharmacy. These devices all have a long spout that delivers the solution through one nostril and out the other to clear everything out, Reddy says.

Here’s how Reddy recommends making a nasal irrigation solution: In a clean glass, combine 8 ounces of distilled or sterile lukewarm water with 1/2 teaspoon of noniodized salt and a pinch of baking soda.

Do not use tap water unless it’s been boiled for three to five minutes — unboiled tap water isn’t safe because it may contain infection-causing organisms, per the FDA.

 Be sure to clean all equipment and make a fresh batch of solution each time you use your kit.

Bellak recommends using a nasal irrigator every day to help clear mucus and reduce inflammation.

4. Use Eucalyptus Essential Oil

Eucalyptus essential oil, with its invigorating, cooling scent, can help relieve some of the pressure. Research shows that eucalyptus essential oil, particularly its main component called 1,8-cineole (eucalyptol) has anti-inflammatory and pain-relieving properties that can help relieve sinus headaches.

You can use eucalyptus oil by dropping some into a diffuser and inhaling the steam or by applying it on your skin. “Inhalation through a diffuser allows the eucalyptus oil’s volatile compounds to reach the respiratory tract, providing relief from congestion and inflammation,” says Bellak. If you use it topically, make sure to dilute it with a carrier oil, after which it can be applied to the chest or temples to provide localized relief, Bellak says.

5. Alternate Hot and Cold Compresses

Applying warmth to the face around the sinus areas increases blood flow, which can reduce sinus congestion and loosen mucus, Reddy says. Meanwhile, “cold compresses may help numb the pain, reduce inflammation, and decrease sinus swelling.” Switching between these temperatures may stimulate blood circulation, encourage drainage, and provide relief from both pain and pressure, Reddy says.

To use hot and cold compresses at home: Start by placing a hot towel or washcloth across your sinuses for about three minutes. Then place a cold compress across your sinuses for 30 seconds. Alternate two more times, and repeat the treatment about four times a day, Reddy recommends.

6. Eat Spicy Foods

Many people find that adding hot sauce to their meals can help clear their nasal passages. That’s because spicy foods contain the compound capsaicin (found in chili peppers), which acts as a natural decongestant by promoting mucus production and drainage.

“For people with sinus headaches, eating spicy foods might prompt a brief increase in runny nose and tears, helping to clear congested passages and ease pressure and pain,” Reddy says.

Capsaicin preparations have been investigated for the treatment of some facial pain syndromes and of rhinitis with promising preliminary results, Reddy says. So if you have the taste (and stomach) for spicy foods, you can try testing your tolerance to help with sinus discomfort.

7. Swipe on Some Vaporizing Ointment

A vaporizing ointment rub like Vicks VapoRub, the balm that almost magically quells coughs, is also a good home remedy for sinus pain.

That’s because vaporizing ointments contain camphor and menthol, which reduce activity in certain receptors that help you detect pain.

 “This can lead to a reduction in pain perception and an improvement in the nasal sensation of airflow, which can alleviate sinus congestion and associated headaches,” says Bellak.

For sinus headache relief, Bellak recommends applying Vicks to the chest and covering the area with a warm, dry cloth. “The warmth can amplify the release of vapors from the Vicks, enhancing the inhalation of its soothing components, which can help relieve nasal congestion,” he says.

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Understanding Diabetic Seizures: Signs, Causes, and Prevention

People experiencing a diabetic seizure will be unable to treat their own symptoms — they will probably lack the presence of mind to understand their situation, or the body control to fix it. Therefore, it is just as important for friends and family to be familiar with these symptoms.

Seizures can cause a variety of temporary abnormal behaviors, sometimes very suddenly, including:

  • Muscles that twitch, jerk, or convulse
  • Loss of consciousness
  • Limbs that go limp or stiff
  • Drooling or staring
  • Clenched teeth

During a diabetic seizure, you may become unconscious, fall, or have convulsions that cause muscles to contract involuntarily, making the body move and jerk out of control. Convulsions can be mild or severe. You may also appear to be in a trance or unable to respond, with eyes blinking rapidly or staring into space, before slipping into unconsciousness.

These symptoms require immediate emergency medical care.

In some cases, a diabetic seizure may occur without warning, especially if it happens in the middle of the night or in people who experience hypoglycemia unawareness.

 Sudden seizures are especially dangerous if they strike people who are engaged in activities such as driving a car or swimming.

For most people with diabetes there will be prior warning signs as blood sugar levels drop towards unsafe levels. Everyone with diabetes should be intimately familiar with the symptoms of (moderate) hypoglycemia, including the following:

  • Shakiness
  • Sweating, chills, and clamminess
  • Irritability or impatience
  • Rapid or fast heartbeat
  • Lightheadedness or dizziness
  • Hunger and nausea
  • Sleepiness or weakness
  • Blurred or impaired vision
  • Tingling or numbness in the lips or tongue

Diabetic seizures can be prevented by noticing some of the above symptoms and reacting appropriately. As long as the person experiencing low blood sugar can still safely eat and drink, treating the condition is often very easy. Fast-acting carbohydrates, like the sugar found in candy or soda, can bring blood sugar back up into a safe range.

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Polio Vaccine: What You Need to Know

The polio vaccine is the safest and most effective way to prevent polio, a dangerous and contagious viral infection that attacks the nervous system. Before the vaccine, polio outbreaks caused lifelong paralysis in thousands of people in the United States. Read on to learn more about the polio vaccine and how it works.
Overview What It Is What Is the Polio Vaccine? The polio vaccine is the primary means for preventing polio. The only type available in the United States is the inactivated poliovirus vaccine (IPV), which contains killed versions of the poliovirus. The vaccine teaches a person’s immune system to recognize and attack the living poliovirus should there be an exposure in the future. There is a second type of polio vaccine: the oral polio vaccine (OPV), used in some parts of the world, which uses living but weakened viruses. IPV is injected into the leg or arm, depending on a person’s age.e60dc2a1-f33c-4a05-9b50-8e3e8e597629519828c7-972b-4001-a0fe-c54eb688da21 Full vaccination against polio with IPV requires a series of four shots, typically administered in childhood. People getting vaccinated as adults may receive a series of three injections.
Why Get the Polio Vaccine? Why Get It Because there is no cure for polio, preventing the disease is even more important. Polio can lead to severe complications, including paralysis, difficulty breathing, and in some cases, death. Though most cases of polio are asymptomatic (don’t have visible symptoms), about 1 in 200 infections can cause irreversible paralysis. Of those paralyzed, 5 to 10 percent die when their breathing muscles become immobilized (cannot move or otherwise function).e60dc2a1-f33c-4a05-9b50-8e3e8e5976295f8a0bba-0b59-47a9-bb66-9f4ff3cd1c09 Meningitis (infection of the covering of the spinal cord or the brain) occurs in about 1 to 5 percent of people with polio.e60dc2a1-f33c-4a05-9b50-8e3e8e59762960ff10ee-84a7-4d14-9e96-80831bfcd3b1 The polio vaccine has eliminated polio in most of the world. Of the three variations of poliovirus that ever existed, two are now eradicated, while the remaining one (known as wild poliovirus type 1 or WPV1) — the type most likely to cause paralysis — is present only in some parts of the world. Since the vaccine was introduced, cases due to WPV1 have decreased by over 99 percent, from an estimated 350,000 cases in more than 125 endemic countries to just two endemic countries, Afghanistan and Pakistan. An endemic country is where a disease is consistently present, typically year-round.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295f8a0bba-0b59-47a9-bb66-9f4ff3cd1c09 Even though the poliovirus has been eliminated from the United States, it only takes a single traveler with the virus arriving from another country to increase the threat level.e60dc2a1-f33c-4a05-9b50-8e3e8e59762960ff10ee-84a7-4d14-9e96-80831bfcd3b1 In 2022, one person in the New York area developed polio that resulted in paralysis, and the virus was found in wastewater in the adjoining and nearby counties, indicating that it had spread in the community. Fortunately, the outbreak ended without further harm.e60dc2a1-f33c-4a05-9b50-8e3e8e597629853e178a-8125-417f-bf3b-e5720ae4bd52 Polio spreads via coughing and sneezing or from coming into contact with the feces of an infected person. Drinking contaminated water, eating foods that have touched contaminated water, and touching contaminated surfaces can also lead to transmission. The poliovirus infects the throat and the intestines and causes flu-like symptoms before possibly spreading to the nervous system and resulting in paralysis.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296e0a47ac-2433-4b71-95aa-b9d966ed79e2
Who Should Get the Polio Vaccine? Who Should Get It All children in the United States may receive four doses of the polio vaccine as part of their routine childhood immunizations. Adults who received childhood vaccines in the United States almost certainly were vaccinated for polio.e60dc2a1-f33c-4a05-9b50-8e3e8e59762945b8af9a-a35a-4e07-b59a-f9799ebf9689 However, the 2022 case of polio in New York underscored potential risks for unprotected adults in the United States. In 2023, the Centers for Disease Control and Prevention (CDC) began recommending that all adults (18 years and older) who are known or suspected to be unvaccinated or incompletely vaccinated against polio complete a primary three-dose vaccination series. The series is given at an interval of four to eight weeks; and a third dose 6 to 12 months after the second.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a43aaa75-1725-491f-9448-ea602eca4368 Adults who are not fully immunized should aim to complete the primary series of the polio vaccine if they plan to travel internationally. Some countries may require those who are departing to provide proof of polio vaccination on the yellow International Certificate of Vaccination or Prophylaxis (ICVP). If adults can’t complete the recommended series schedule before traveling, the CDC recommends an accelerated schedule (three doses administered at least four weeks apart).e60dc2a1-f33c-4a05-9b50-8e3e8e59762903e4803c-ad1c-4e4a-adb2-6ea1a00180eb
Who Shouldn’t Get the Polio Vaccine? Who Shouldn’t Get It While the polio vaccine is safe for nearly everyone, some people shouldn’t get the vaccine. Reasons not to get the polio vaccine include: Severe Allergic Reactions Individuals who have had severe allergic (anaphylactic) reactions after a previous vaccine dose or after taking streptomycin, polymyxin B, or neomycin should not receive the shot. The polio shot contains trace amounts of streptomycin, polymyxin B, and neomycin, and people who are sensitive to these antibiotics can also have hypersensitivity reactions to vaccination. Pregnancy Although there is no evidence that the polio vaccine causes harm to pregnant individuals or their fetuses, it shouldn’t be given during pregnancy if there is not an increased risk of infection. However, a pregnant woman who is at increased risk for exposure and requires immediate protection against polio should receive the vaccine in accordance with the recommended schedules for adults, per the CDC.e60dc2a1-f33c-4a05-9b50-8e3e8e597629506076af-c189-4d05-98c4-2f3132a165d8
How Many Doses of the Polio Vaccine Do You Need? Doses Needed As part of the routine vaccines recommended for all babies and children, children should get a polio vaccine dose at the following ages: 2 months 4 months 6 to 18 months Between 4 and 6 years For adults or older children who have missed doses or are unvaccinated, the primary series consists of three doses: two doses separated by four to eight weeks, with a third dose given 6 to 12 months after the second.e60dc2a1-f33c-4a05-9b50-8e3e8e597629910cb140-4dba-47ef-aab3-3fbee9eca9b7
How Well Does the Polio Vaccine Work? Effectiveness Two doses of inactivated polio vaccine are 90 percent effective or more against paralytic polio, and three doses are 99 to 100 percent effective.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d0935c15-d856-45a3-967e-6bba1f09fc77
How Long Does the Polio Vaccine Last? Do Adults Need a Booster? How Long It Lasts It is not known how long people who received the polio vaccine in injected form in the United States will be protected, but they are most likely protected for many years after a complete series. A 2009–2010 national survey showed that a high percentage of children and adults had protective antibodies against poliovirus, including adults who had received oral polio vaccine (OPV) as children decades earlier. Adults who completed their polio vaccination series as children and are at high risk may need a booster and should consult their healthcare provider. Situations that increase risk include traveling to areas with ongoing polio outbreaks or working in healthcare settings.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299183dceb-cc89-4661-953f-9f5a36ebc93d
Is the Polio Vaccine Safe? Safety Serious side effects of the polio vaccine are rare, and the benefits far outweigh any potential risks. Polio can lead to permanent paralysis and even death. The vaccine risks are mild side effects that go away within a day or two.e60dc2a1-f33c-4a05-9b50-8e3e8e597629de803c3c-42f2-4e1a-98bd-ac2e62fc7a9e Vaccines don’t always go through placebo-controlled trials, but they do go through rigorous safety testing. In some cases, it isn’t ethical to hold placebo-controlled trials (in which some people who think they are receiving a vaccine are getting a fake), such as when a vaccine has already been shown to prevent disease and death.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295538ba41-4b73-4f64-b4f1-01fb43d3c6c2 Is the Polio Vaccine Linked With Cancer? A portion of Americans who got the polio vaccine between 1955 and 1963 received doses that were contaminated with SV40, a carcinogenic material. The virus causes cancer in rodents, but it has not been shown to cause cancer in humans. There isn’t evidence that people who were vaccinated during this period have developed cancer at a higher rate than those who were not.e60dc2a1-f33c-4a05-9b50-8e3e8e59762944e532c1-7ba7-4fd8-9c81-79cb0e5fa1a2
Side Effects of the Polio Vaccine Side Effects Most people experience no side effects from the polio vaccine, but some may have mild reactions, such as redness or swelling at the injection site. These side effects usually go away within a few days. Severe reactions, like allergic responses, are extremely rare.e60dc2a1-f33c-4a05-9b50-8e3e8e597629be40f77f-dc1c-4958-af8f-eb61c9f46367
Polio Vaccine Cost and Insurance Coverage Cost The cost of the polio vaccine is typically covered by insurance. Vaccination through public health programs is often low cost or free. Out-of-pocket cost for a single dose of the vaccine may cost between $70 and $85.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299f84fadb-9a2e-4552-88d3-06c7b79681fd
Where to Get a Polio Vaccine Near You Your child’s healthcare provider or your local health department are the best places to get recommended childhood vaccines. Vaccines may also be available at your local pharmacy. Visit the CDC’s vaccine-finder tool for more information on where to get the vaccine.
The Takeaway The polio vaccine is safe and highly effective in preventing the spread of polio, a disease that can cause paralysis and death. All children in the United States should receive the polio vaccine as part of their routine immunizations, with four doses given between 2 months and 6 years old. Adults who are unvaccinated or incompletely vaccinated should get the full primary vaccine series, especially if they are traveling to areas where polio is still a threat.
Resources We Trust Cleveland Clinic: Polio Immunize.Org: Ask the Experts: Polio Centers for Disease Control and Prevention: Polio Vaccine Recommendations World Health Organization: Poliomyelitis (Polio) NewYork-Presbyterian Hospital: What You Need to Know About Polio and How to Protect Yourself

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What You Need to Know

A low-calorie diet can be a safe, straightforward, research-confirmed path to weight loss.

 There are plenty of journals, calculators, apps, and other resources available for calculating your progress. Plus, a standard lower-calorie eating plan doesn’t typically restrict any specific foods (or their timing) as you might opt for smaller portions or lower-calorie substitutes.

Some popular diet plans take users to extremely low levels, though. The HCG (human chorionic gonadotropin) diet, for example, supplies as low as 500 calories per day.

 The Master Cleanse, a 10-day, liquid-only diet consisting of lemon juice, purified water, cayenne pepper, and tree syrup, also tops out at a few hundred calories per day. Other low-calorie eating plans, like the TLC diet (short for “therapeutic lifestyle changes”), hover near the 1,400- to 1,750-calorie mark, or calculate a specific number based on your gender, current weight, and goal weight.

This slash-and-burn approach to calories may come with downsides. Meticulous tracking of numbers and portion sizes can create disordered eating behavior in some people.

 If you have a history of an eating disorder or a problematic relationship with food, it’s best to approach calorie counting with caution; enlist the help of a therapist or registered dietitian, if possible.

Regardless of your mental health history, a super-low-calorie diet may not be sustainable in the long term. We all need calories for survival. If your body senses it’s not getting enough, it will fight the process with a mechanism known as “starvation mode.” “Starvation mode is a defense mechanism that the body uses to prevent fat loss and starvation. The idea is, your body wants to use your fat to keep you alive, so you don’t burn as many calories,” says Felix Spiegel, MD, a bariatric surgeon at Memorial Hermann Medical Group in Houston. “This lowers your metabolic rate, which means you’re using less calories. If you cut back your calories too much, it hinders weight loss.”

To prevent weight loss plateaus, Dr. Spiegel recommends a goal of 1 to 2 pounds lost per week. “If you lose more than that, you’re losing body fluid and muscle mass.”

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7 Tips for Cleaning Your Home When It Feels Impossible

If you’re struggling to keep up with house cleaning duties due to depression, here are some simple ways to help you start tackling them.

1. Start Small

You don’t have to clean your whole house in one swoop, adds Mairanz. “Starting small sets us up for success with larger projects,” she says. “Starting with something easy like putting clothes in a hamper will help maintain motivation through positive feedback loops.” Positive feedback loops are actions that help to reinforce change.

 For instance, seeing a full clothes hamper can make it easier to take the next step of putting the clothes in the washer.

Try it by identifying your three most important house cleaning goals. Focus on completing the first of those tasks, then try to tackle the others one at a time.

Concentrating on just those small steps makes it easier to get started and build that inertia to keep going, says Karen Lynn Cassiday, PhD, a clinical psychologist and managing director of the Anxiety Treatment Center of Greater Chicago. “It’s like jump-starting a car when you have a battery that doesn’t work,” says Dr. Cassiday.

2. Reframe Negative Self-Talk

“People with depression will start to criticize themselves and say, ‘I’m so lazy,’” says Cassiday. This negative self-talk can actually end up hindering your productivity rather than motivating you to get things done, she says.

If you notice that you’re speaking negatively to yourself, it can help to immediately replace those thoughts with positive ones. Positive self-talk can help increase self-esteem and boost motivation, which in turn can lead to improved productivity, adds Cassiday.

Some strategies for positive self-talk include:

  • Be encouraging and gentle to yourself by looking at negative thoughts objectively. Then respond with a compassionate evaluation of what is good about yourself.
  • Don’t say anything to yourself that you wouldn’t say to someone else.

3. Don’t Wait Until You Feel Good to Get Started

When people with depression have good days and they struggle less with their symptoms, they may use those feelings as motivation to complete a task, says Cassiday. For example, they may clean their kitchen because they know it will bring them a sense of satisfaction and accomplishment later on.

But you can’t rely on feeling good as your motivation strategy all the time. Part of the reality of having depression is recognizing that there will be some days when you don’t feel good — but you’ll still need to get things done on those days, too.

“So we have to teach people to first learn to ignore the part of themselves that says, ‘I need to feel good in order to do it,’” says Cassiday. “You can’t wait for feeling good. You have to think about something that’s really important, which is that action that creates motivation.”

4. Prioritize High-Impact Cleaning Tasks

Cassiday recommends choosing tasks that create a “high impact” first to help you better recognize the value of your efforts.

What that means: “A bed takes up a large chunk of space in a room, so if you actually make it, it has a rather large effect in terms of the aesthetic appearance as compared to, say, picking up five pieces of trash,” she says.

5. Ask for Help

If a family member or friend can assist you with cleaning duties, the extra help may jump-start your motivation.

“People with depression tend to withdraw and self-isolate. Reaching out to a friend or loved one is a big step toward combating depression and can have immediate effects, not just on the physical space, but also on the emotional,” says Mairanz.

If possible, Cassiday says, do your best to ask for help before you feel embarrassed by a mess. For instance, if you haven’t been able to fold and sort laundry for a few weeks, it’s a good idea to try to reach out for help before the situation becomes unmanageable.

Also, if you have the resources, hiring a cleaning service may be a valuable option.

6. Track Your Wins, No Matter How Small

Actually write them down, Cassiday says. Include cleaning-related accomplishments as well as other wins. She calls this a “what I did list,” as opposed to a “to-do list.”

“When people are depressed they tend to vastly underestimate the effect and value of their efforts,” Cassiday says. “This helps you see that you are actually getting somewhere.”

7. Give Yourself Grace

You may also need to adjust your expectations when it comes to keeping your living space clean. Realize you may not have the energy or focus that you used to — and that’s okay, says Cassiday.

It’s important to remind yourself that a messy or disorganized house doesn’t mean you’ve failed in any way. “You are not alone with having a hard time with this, and it’s nothing to be embarrassed about. We all go through ups and downs with our mental health, and our space is often a reflection of that natural process,” says Mairanz.

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Older Adult Children of Divorce May Have Higher Stroke Risk

Older adults whose parents divorced may have a greater risk of stroke compared with adults whose parents stayed together, a new study finds.

“Our study indicates that even after taking into account most of the known risk factors associated with stroke — including smoking, physical inactivity, lower income and education, diabetes, depression, and low social support — those whose parents had divorced still had 61 percent higher odds of having a stroke,” said first author Mary Kate Schilke, a psychotherapist and university lecturer in the psychology department at Toronto’s Tyndale University, in a press release.

Research shows that in the United States, 41 percent of first marriages, 60 percent of second marriages, and 73 percent of third marriages end in divorce.

Stress or Trauma During Childhood Can Lead to Numerous Health Issues

Evidence suggests that adverse childhood experiences (or ACEs) — stressful or traumatic events that children may face, such as physical, emotional, or sexual abuse, neglect, or family dysfunction — can impact both mental and physical health later in life.

More than 60 percent of U.S. adults report experiencing at least one adverse childhood experience, and 16 percent have four or more types of ACEs. At least 5 out of the top 10 leading causes of death are associated with these experiences.

The Divorce-Stroke Connection

To examine the link between divorce and stroke risk, researchers used data from more than 13,000 adults who were part of the 2022 Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS, a collaborative project between state health departments and the Centers for Disease Control and Prevention, collects health-related data via telephone surveys.

The participants were 65 or older, and 57 percent female, 79 percent white, 9 percent Black, and 12 percent Hispanic or other races.

The researchers excluded participants who had been exposed to sexual or physical abuse, says senior author Esme Fuller-Thomson, PhD, a professor of social work and director for the Institute of Life Course and Aging at the University of Toronto.

“Our research wanted to clarify the association between parental divorce and stroke by avoiding any potential confounding with childhood abuse,” says Dr. Fuller-Thomson.

Of the participants, 7.3 percent had experienced stroke and 13.9 percent had parents who’d divorced before they turned 18 years old.

Researchers “were saddened, but not surprised,” that parental divorce was associated with greater odds of stroke, says Fuller-Thomson.

“But we were surprised that the association between parental divorce and stroke was of similar magnitude to two well-established risk factors for stroke: diabetes and male gender,” she says.

Staying in Childhood Home With Trusted Adult Didn’t Reduce Additional Stroke Risk

“We found that even when people hadn’t experienced childhood physical and sexual abuse, and had at least one adult who made them feel safe in their childhood home, they still were more likely to have a stroke if their parents had divorced,” said coauthor Philip Baiden, PhD, associate professor in the school of social work at the University of Texas in Arlington, in the press release.

Other forms of childhood adversity — emotional abuse, neglect, household mental illness, substance abuse, and exposure to parental domestic violence — were not significantly associated with stroke in this study.

Why Might Parents’ Divorce Increase Stroke Risk?

The study wasn’t designed to uncover why children of divorce could have a higher stroke risk, but the researchers speculate there could be both biological and social factors at play.

“From a biological embedding perspective, having your parents split up during childhood could lead to sustained high levels of stress hormones. Experiencing this as a child could have lasting influences on the developing brain and a child’s ability to respond to stress,” said Fuller-Thomson in the statement.

Socially, divorce was much less common for older generations, and much more stigmatizing. For these reasons the level of parental conflict that would have led to divorce may be higher, thereby making the experience more traumatic, the study authors wrote.

Fuller-Thomson acknowledges that this study only shows an association, not direct causation — it doesn’t prove that divorce causes an increase in stroke risk, only that the two things are related.

There are other additional limitations to the findings. Some people may have died from stroke before age 65, and therefore wouldn’t be included in the study group. The survey also couldn’t capture when the divorce occurred, or the level of contact with the noncustodial parent, the authors wrote.

Would Divorce Have the Same Impact on Gen-Xers and Millennials?

This was the second study on the association between parental divorce and stroke. A previous study used data from 2010. That study found that divorce was linked to higher stroke risk in males but not females.

Both these groups represent older Americans: the so-called “Silent Generation” born between 1925 and 1945, and Baby Boomers, born between 1946 and 1964.

Trauma and associated stroke risk may or may not be present in younger people, including Gen-Xers and Millennials, according to the authors. “Future research is needed to investigate generational differences in the parental divorce-stroke association,” they wrote.

How to Reduce Your Stroke Risk

We are hoping that adults with divorced parents will be particularly vigilant about their health,” says Fuller-Thomson.

She recommends the following steps to reduce your risk of stroke:

  • Get regular check-ups.
  • Maintain low blood pressure and low cholesterol.
  • Don’t smoke.
  • Keep physically active.
  • Maintain a healthy weight.
  • Eat more fruits and vegetables.
  • Decrease salt intake.
  • Don’t drink excessively.

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Will Semaglutide (Ozempic) Silence Food Noise and Help You Lose Weight?

Laura Hall was doing everything right.

After a lifetime of profound struggles with compulsive eating, the Fort Worth, Texas, resident had finally put together all the pieces of a healthy lifestyle. She was eating a plant-based diet and had cultivated healthy exercise habits. Around 2017, she hit her goal weight.

But in 2022, at age 52, Laura found herself putting on menopausal weight and didn’t seem able to stop gaining. And though she had largely gotten her binge eating under control, and she was satisfied with her wholesome diet, the compulsion to overeat still haunted every meal.

When she asked her doctor about semaglutide, the blockbuster weight loss drug sold as Ozempic and Wegovy, she wasn’t an obvious candidate for it. The drug is not recommended for people without diabetes or those who do not have a clear medical reason to lose weight, and Laura only wanted to lose about 30 pounds. Experts do not know if patients like Laura can use semaglutide safely.

As it turned out, semaglutide didn’t just help her get to her goal weight — it freed her from the intrusive and obsessive thoughts about food that had plagued her for decades.

“I never knew how to create ease around food and my body, and now I have it,” Laura says.

Semaglutide, she says, was “the last piece of the puzzle.”

A Lifetime of Compulsive Eating

Laura’s compulsive eating had an early and very traumatic beginning: “I was sexually abused as a kid, and food was my coping mechanism. I started overeating when I was very, very young.”

She also grew up in a genetic and cultural environment that seemed primed to encourage unhealthy eating habits. “My entire family is obese,” she says. One grandparent, who died of the complications of type 2 diabetes, weighed about 400 pounds.

Laura spent much of her adolescence with bulimia, repeatedly binge eating and then purging by making herself vomit. In college, she stopped vomiting but pivoted to exercise bulimia, working out “excessively,” she describes, to compensate for her compulsive eating. “I was still bulimic, but I wasn’t throwing up,” she explains. When she looks back, she’s shocked “at the amount of abuse I put my body through just so I could eat a bunch of s***.”

The binge eating never went away, and as she aged, Laura’s weight fluctuated depending on how much time she devoted to working out. In her early thirties, Laura taught aerobics, raced bikes, and competed in triathlons. But a career shift cut into her exercise time, and “that’s when the weight just piled on,” she says.

Laura took drastic action. She had laparoscopic adjustable gastric band (lap band) surgery, a procedure in which doctors place a silicone band around the stomach to reduce its capacity. At only 200 pounds and not yet clearly suffering from obesity-related health issues, Laura was not an ideal candidate for the procedure. Her insurance wouldn’t cover it, and she paid for the surgery out of her own pocket.

Lap band surgery is supposed to reduce hunger levels. According to the Cleveland Clinic, the “upper stomach pouch will fill up quickly, making you feel fuller faster.”

Ideally, the size reduction allows patients to eat fewer calories with relative ease. But Laura sometimes kept eating even when she wasn’t hungry, and the belt around her stomach only made her binge eating even more problematic.

“If you eat too much, it displaces the lap band, and then you can’t eat anything — you can’t even keep water down. It’s a miserable experience,” she says. “I overate to the point where it slipped, and I had to get revision surgery, not once but twice.”

It was also a financial disaster for Laura. She had to cash out retirement funds to help pay for the additional procedures, and when she decided that she should have the band permanently removed, she couldn’t afford to have it done. Eventually, she flew to San Diego and crossed the border to Mexico, where a Tijuana clinic offered band removal surgery for a fraction of the price she would have paid in the United States.

Losing Weight the Hard Way

In early 2016, Laura weighed about 180 pounds, “heavier than I wanted or needed to be,” she says. A confluence of factors — including the death of her mother, a grueling experience, and the introduction of a community-led healthy living Blue Zones Project initiative in Fort Worth — finally inspired Laura to make healthy changes.

“I made a major lifestyle shift. I started eating a whole-foods, plant-based diet and stopped drinking alcohol. My weight dropped to about 125 pounds within a year,” she says. “I’d make one small change every few weeks. It wasn’t about weight — it was about health, and that was a new thing for me.”

Though her family initially mocked and doubted her, Laura stuck with the changes and is still enjoying her new diet today. “That was my life, and I was happy. It’s a good way to live,” she says.

But it was never easy. Though Laura was able to manage her eating compulsions for the first time in her life, “it was a constant, white-knuckle struggle — constant,” she describes.

An Extra 30 Pounds

Like so many others, Laura gained more than a few pounds during the pandemic. But when she got back on track with her good habits, the weight simply would not come off.

She attributes the difficulty to the hormonal shifts characteristic of the menopausal transition, which are known to affect metabolism and cause weight gain. “I was doing the exact same movement and eating routine, but I had 30 extra pounds on,” she says. “It doesn’t sound like much, but it was a lot to me.”

Despite her fastidious lifestyle, Laura was gaining about two pounds per month. This caused immense frustration because she was sure that she was making healthy diet and exercise choices. It seemed clear that she’d never again approach her goal weight without some kind of medicinal help. Finally, inspired by a friend’s success, she asked her doctor about semaglutide, the blockbuster weight loss drug originally developed to treat type 2 diabetes.

Laura didn’t satisfy any of the established medical criteria for semaglutide: She doesn’t have diabetes and at this point was only barely overweight. Semaglutide is associated with a large number of side effects and risks, both known and suspected. These risks could be increased in patients who are not medically qualified to use the drug in the first place. Some experts, for example, are concerned by evidence that semaglutide causes excessive muscle loss, as reported by Diabetes Daily, and a CNN investigation identified especially severe cases of stomach paralysis known as gastroparesis.

European regulators, meanwhile, are investigating reports that the drug has caused self-harm and suicidal ideation.

Although her doctor was willing to write her an off-label prescription, Laura couldn’t afford the $1,000 per month out-of-pocket cost.

To find affordable semaglutide, Laura turned to the internet, which hosts a growing network of online healthcare providers and weight loss programs offering less expensive compounded weight loss drugs with only a bare minimum of medical oversight. Laura took advantage of one supplier’s carelessness by fibbing on her intake form: “I added a few pounds and took off an inch of height, so I’d be sure to qualify,” she admits.

Experts have cautioned against using less scrupulous online healthcare providers, and the U.S. Food and Drug Administration has warned that compounded forms of semaglutide may lack the proven safety or efficacy of Ozempic and Wegovy.

But for Laura, the medicine has been transformative.

Food Noise Relief

Laura proclaims that semaglutide ended her lifelong battle with compulsive eating “immediately. The food noise in my head shut the f*** up for the first time in my life.”

Others have experienced the same relief. They say that semaglutide is helping silence their food noise. Although there’s no precise definition or measurable medical standard, food noise refers generally to intrusive thoughts and preoccupations about food. Laura spent most of her life obsessing over what she ate or was about to eat.

“It’s a freedom that I never thought I’d have,” she says, stifling tears. “I’ve been struggling with this since I was 8 years old. That’s a lot of years. I’m 52 years old — do the math.”

Semaglutide doesn’t just suppress hunger; it appears to have an effect on the brain’s reward system, too. Researchers believe that semaglutide could be a powerful anti-addiction drug, and anecdotal reports indicate that it may help quell compulsive behaviors such as nail-biting and binge shopping. On the flip side, some have found that squelching the desire for food takes the joy out of eating and isn’t worth it.

For Laura, her relief from food preoccupations has allowed her to reevaluate the history of her own diet failures. In recent years, for example, Laura experimented with intermittent fasting and blamed herself when the trendy eating pattern did not help assuage her compulsive tendencies. “I thought it was my fault that fasting wasn’t easy,” she says. Now she believes that her failures were chemical — an imbalance that semaglutide helps correct — rather than the result of insufficient willpower or commitment.

Better Living Through Chemistry

With her food noise and appetite suppressed, Laura easily lost the 30 pounds she wanted to lose. She’s holding steady at about 125 pounds.

Now that Laura has hit her goal weight, how long does she intend to use semaglutide or a related drug?

“Forever,” she says

She’s happy with where she is now in her weight loss journey.

“Life doesn’t have to be as hard as I’ve made it. Who says it has to be hard? Semaglutide makes it easy for me,” she says. “I’m gonna let it be easy.”

Everyday Health‘s Weight Loss Reframed Survey queried 3,144 Americans nationwide ages 18 and older who had tried losing weight in the previous six months. The study was fielded between July 10 and August 18, 2023, across demographic groups, genders, and health conditions. Survey recruitment took place via an online portal, in app, and via email. The margin of error for the sample size of 3,144 is +/-1.7 percent at a 95 percent confidence level.

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Everyday Health’s Weight Loss Survey Reveals the Top 3 Keys to Successful Weight Loss in the Age of Ozempic

“When it comes to weight loss, many approaches work, but the key is sustainability,” says Sean Hashmi, MD, a nephrologist and obesity medicine specialist in Southern California, a member of the American College of Lifestyle Medicine, and a member of Everyday Health’s Health Expert Network.

Other experts agree.

“When I’m helping patients find a plan for weight loss, I’m not saying, ‘Hey, let’s try this for 10 weeks and then switch,’” says Fatima Cody Stanford, MD, MPH, an obesity medicine physician at Massachusetts General Hospital and an associate professor of medicine at Harvard Medical School in Boston. “We’re trying to find things someone will do consistently for the rest of their life.”

While consistency is crucial, Dr. Stanford says that doesn’t mean a person’s approach needs to be inflexible or oversimplified. According to the survey, people who lost weight tended to employ more tactics overall than people who did not lose weight. They also tended not to be rigid or routine about diet and exercise. “I tell people the flavor can change, but the structure should be the same,” she says.

For example, Stanford says people who are incorporating exercise into their weight loss plan should feel free to switch up their workouts from time to time. The important thing is that they continue to exercise regularly. “I need variety when I’m training in order to stay motivated and excited about working out,” she says.

Likewise, dietary approaches to weight loss shouldn’t be too narrow or overly prescriptive. If your plan requires that you weigh all your food and count every calorie, Stanford says you will have a hard time sticking with it.

Finally, experts said that the tactics a person employs to lose weight shouldn’t be solely related to diet and exercise (although those are important). “We should broaden our focus to include things like stress levels, sleep quality, and mental health,” says Kayli Anderson, RDN, a nutrition expert and a member of the American College of Lifestyle Medicine and Everyday Health’s Health Expert Network.

For those interested in the newest weight loss medications, our experts say they’re worth considering. While the survey found that more than half of respondents were not interested in trying these medications, those who had tried them found them to be very effective.

“It’s not just hype,” Stanford says of these drugs. “Patients on these medications tell me they don’t even have to think about eating less.”

Key Finding 2: Arm Yourself With Information

Among the people in our survey who successfully lost weight, 70 percent started their weight loss journey with “a higher level of knowledge” on how to lose weight — compared with 52 percent of those who maintained or gained weight.

Also, according to our survey, 6 in 10 people reported they knew how to lose weight. Ten percent said they didn’t know where to start.

The survey also showed that a conversation about weight loss with a healthcare professional might be worthwhile: Fifty-nine percent of all respondents said their doctor or other healthcare provider had talked to them about losing weight, while 53 percent of all respondents said they had not asked their doctor or provider for help with weight loss.

Even if you feel you have a good handle on the best approaches to weight loss, consulting with an expert — either a registered dietitian-nutritionist or a medical doctor who specializes in weight loss — is a good idea. “They are trained in helping people set realistic health goals,” Anderson says. “They can also educate people about nutrition and help them develop personalized plans.”

She recommends visiting the website of the American College of Lifestyle Medicine.

 “They represent health professionals trained in addressing prevention and treatment of disease with lifestyle,” she says. “You can search the directory on their site to find a provider to work with.”

Another reason to consult with an expert: Even evidence-backed weight loss strategies aren’t going to work for every person and every situation. “Treatment of excess weight doesn’t have a one-size-fits-all answer,” says Deepa Sannidhi, MD, an associate clinical professor at UC San Diego Health in California.

While the internet can provide useful (and free) weight loss information, it’s also rife with misinformation. “When you’re looking for advice online, you should always check the source,” Anderson says. Once again, she recommends seeking out recommendations from registered dietitians or weight loss physicians, or, if you don’t have access to one of these professionals, turn to credible online sources to arm yourself with information. “EatRight.org is a great dietitian-created website to learn from,” she adds.

Key Finding 3: Understand Your Motivation and the Connection Between Weight and Mental Health

Of all the hurdles that stand between a person and their weight loss goals, survey respondents were most likely to highlight stress and motivational problems.

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What Causes Sleep Apnea?

While anyone can develop obstructive sleep apnea, certain factors can increase your risk for this condition or mean you may be more likely to already have it.

Obesity

Obesity is the most common risk factor for obstructive sleep apnea. “Fat deposits in the neck and around the tongue and palate make the airway much tighter and smaller,” says sleep medicine specialist Neeraj Kaplish, MD, medical director of sleep labs and clinics and clinical professor of neurology at the University of Michigan in Ann Arbor. “It becomes much more [closed up] during sleep when you’re lying down.” (It should be noted that thin people can also have obstructive sleep apnea and that not all individuals who are overweight have the condition.)

Large Adenoids or Tonsils

Some people have large tonsils or adenoids, or smaller airways, which can contribute to breathing problems during sleep. Large adenoids and tonsils are the most common cause of obstructive sleep apnea in children, says Ronald Chervin, MD, professor of sleep medicine and neurology and section head for sleep disorders at the University of Michigan in Ann Arbor. Adenoids usually shrink by the teen years.

Jaw Misalignment or Size

Some conditions or genetic factors can lead to an imbalance in facial structure that can cause the tongue to sit farther back in the mouth and lead to sleep apnea, says Robson Capasso, MD, chief of sleep surgery and professor of otolaryngology and head and neck surgery at Stanford University School of Medicine in California.

For instance, a lower jaw that’s shorter than the upper jaw, or a palate (the roof of your mouth) that’s shaped a certain way and collapses more easily during sleep can contribute to obstructive sleep apnea.

Family History of Sleep Apnea

If obstructive sleep apnea runs in your family, you may be at increased risk for having the condition. How your airway is shaped and your cranial facial characteristics can be inherited from your relatives, which can all play a role in whether and why you develop sleep apnea.

Chronic Nasal Congestion

People who have persistent nasal congestion at night (regardless of the cause) are more likely to develop obstructive sleep apnea, probably because of the narrowed airways.

Smoking

People who smoke are 3 times more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking can lead to inflammation and fluid retention in the upper airway, which can affect breathing as well as how well the brain communicates with the muscles that control breathing.

Using Alcohol, Sedatives, or Tranquilizers

Using these substances can increase the relaxation of the muscles in the throat, making obstructive sleep apnea worse.

Asthma

Having asthma is also a risk factor for obstructive sleep apnea. The relationship between the two conditions works both ways, Chervin explains: “Sleep apnea can make asthma worse and asthma can make sleep apnea worse.”

Medication, Such as Opioid Pain Relievers

The neurological communication that happens between the brain and body to regulate breathing can be numbed by benzodiazepines and opioids, says Dr. Capasso. As a result, these drugs reduce airway muscle activation and can contribute to sleep apnea.

Gender and Age

Sleep apnea can occur at any age, but being a male and getting older both put you at increased risk of developing obstructive sleep apnea and central sleep apnea, says Dr. Kaplish. “We don’t really understand why, but it may have to do with fat distribution and hormones.” For instance, as we age, fatty tissue may increase in the neck and around the tongue. Women are also more at risk if they’ve gone through menopause.

High Blood Pressure (Hypertension)

Having hypertension may increase your risk of having obstructive sleep apnea, and untreated sleep apnea can also lead to hypertension.

Diabetes

One study found that people who have type 2 diabetes were 48 percent more likely to have sleep apnea than those without diabetes who were diagnosed with obstructive sleep apnea.

Being overweight or having obesity may be the link, but there are people of normal weight who have both sleep apnea and diabetes. Insulin resistance in diabetes may independently increase risk for apnea, too, while inflammation from apnea may increase risk for diabetes, the researchers note.

History of Stroke

Prior stroke is linked to both obstructive sleep apnea and central sleep apnea, but it’s not clear which is causing which, Dr. Chervin says. “As many as three-quarters of stroke patients have sleep apnea, and sleep apnea also raises the risk for stroke,” says Chervin. Sleep apnea leads to low oxygen levels and high blood pressure, both of which can increase one’s risk of a future stroke.

Heart Failure

Congestive heart failure can also increase your risk for obstructive sleep apnea and central sleep apnea.

Heart failure can cause retention of sodium and water, and doctors suspect that the excess fluid may enter the lungs at night and lead to obstructive apnea.

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